Halitosis is commonly known as bad breath and is caused by bacteria in the mouth that put off odorous sulfur compounds. The causes of bad breath are numerous, but typical reasons include naturally-occurring bacteria on the tongue, periodontal gum disease, and dietary habits.
Although halitosis is a common affliction that affects approximately 25 percent of the population in chronic form and more in transient form, many may imagine that they have halitosis even when diagnosed otherwise. Those who suffer from extremely overstated concerns about having bad breath have halitophobia, or delusional halitosis. This affliction is estimated to be present in up to 25 percent of patients who are seeking professional consultation on halitosis, and it is estimated that one-half to one percent of the adult population may suffer from halitophobia.
Society places a great deal of emphasis on fighting bad breath with consistent messages for mouthwash, mints and chewing gum in mainstream media. While many breath treatments do actually positively affect oral hygiene, those who take this emphasis to an obsessive or extreme degree may be suffering from halitophobia.
Causes of halitophobia can be related to a variety of other psychological syndromes such as delusion, hypochondria and obsessive compulsive disorder (OCD). It is most closely related to Olfactory Reference Syndrome, a sub-category of body dysmorphic disorder, an affliction in which a person is overly obsessive that his or her own body odor is unpleasant. People suffering from halitophobia are excessively self-conscious about their breath and they tend to compulsively clean their mouths by brushing teeth, using breath fresheners and mouth rinses. Avoidance behavior, social phobia and social isolation are common outcomes of halitophobia. Very extreme cases can lead to depression stemming from these chronic fears about having halitosis.
The diagnosis for halitophobia first starts with a professional, clinical test for halitosis usually through a dentist or specialty breath clinic. Bad breath stems from many causes but it commonly results in the presence of sulfurous emissions such as volatile sulfur compounds (VSCs) and indole, skatole and polyamines in the mouth from the presence of bacteria.
A professional diagnosis can measure the levels of these odorous gases and bad-breath-producing enzymes present in one’s breath in order to determine the level of halitosis. A professional can also use an organoleptic test, which consists of the clinician smelling and rating a patient’s breath from a number of distances, to tell the degree of the halitosis condition. If a patient persists in believing that he or she suffers from chronic bad breath, even after being ruled out through these tests as not having halitosis or having successfully completed a treatment course that eliminated the bad breath, that patient may then be diagnosed with halitophobia.
Once a patient is confirmed not to have bad breath, but is still excessively concerned with it and is diagnosed with halitophobia, he or she should then be referred to a psychological specialist for treatment and counseling. Often, underlying mental health issues such as hypochondria or OCD are the root cause of halitophobia, so it is very important for the patient to seek a certified psychotherapist in order to properly treat all the underlying causes. As each patient’s causes and therapy regimen for halitophobia may be different, a professional psychological specialist who can understand all the variable mental facets of the affliction is essential to any successful treatment.
Although most people experience bad breath at some point (and up to a quarter of the population has some form of chronic halitosis) delusion halitosis sufferers do not have chronic bad breath but are obsessive over the possibility of it. Delusional halitosis or halitophobia can be very debilitating to those experiencing it because it adversely affects their confidence in social situations and can amplify obsessive compulsive practices and tendencies. Those who may have been diagnosed with halitophobia are typically recommended to seek professional psychological counseling for effective treatment.